Friday, 26 September 2014

Depressing Mental Health Services

I can't pretend to be an expert on the nature or funding of mental health services of course, or the NHS in general. I have somewhat more expertise in the area of depression, since I seem to have been depressed rather a lot although I never bothered to go to the GP about it or even have counselling. When I have had counselling, it's not been for depression because although I was depressed I didn't consider it a problem. After all, why would I not be depressed? Surely if I was happy I would be out of touch with reality, wouldn't I?

None of this should be taken as implying any criticism of the quality of service or what people are doing with their resources, or the nature of treatment. That's not what this is about.

Just as I have direct experience of depression, I am now gaining first hand experience of mental health services, as are other people around me, though that's nothing new. More specifically, I think, and note that word "think", which I'll come back to, I'm waiting for the gender clinic to see me. In a way, this is not a bad thing because I fully expect seeing the gender clinic either to involve being laughed off as a pathetic wannabe loser or it constituting, as I've said so many times, a nail in the coffin of my relationship to a woman who really is the love of my life, around whom I orbit, tidally locked (look it up if you like, this isn't an astronomy blog), so maybe I will be waiting forever and that's OK, to an extent. Moreover, what I've already managed to do has made major inroads into my anxiety, depression and the rest because the oestrogen now means my brain has a healthy level of serotonin sloshing about, something which Hypericum for example never achieved, and of course because I have a sense of doing something about the number one problem in my life, so my personal situation is far from grim.

Getting back to that word "think" though, and taking it in two directions, I have a letter from a psychiatrist which I carry about with me so I can do things like use the Ladies. It says I have a referral to the gender clinic, and I was told to expect a wait of around thirteen weeks although I also have the figure of six months in my mind from somewhere. I am not now depressed. However, in spite of the fact that I have that concrete piece of evidence available to me, I am now beginning to doubt that this referral is real because I've now been waiting quite a while. I recognise this kind of doubt from the Before Time. It used to set in when something which seemed too good to be true was about to happen, such as acceptance on a course (jobs have never happened to me but I imagine the feeling might be similar), the start of a romantic relationship or somewhere to live. It has a peculiar double-sided feel to it because I can imagine reassuring a friend that something good will happen in spite of what she perceives as a setback and at the same time I am personally experiencing this doubt. It's OK though, I wouldn't want to exaggerate this. The other aspect of that "think" is that it involves thinking. I've been given ample opportunity to overthink this due to the long wait. I'm also my own worst enemy here as I feel the need to isolate myself from sources of support in order to have what feels like a fair discussion with Sarada, who has very little support for her position.

Transfer this to the more common mental health issue of depression and a similar picture emerges, but unlike this, that is all over the place. It's the common cold of mental illness. I can now all too easily imagine someone suffering from depression sitting and waiting for mental health services to help. I have kind of been in this position although it was for a counselling place and although I was depressed, depression in my view was a good thing - why shouldn't I suffer? Why should I have any relief from that? And so on. I'm sure you've all been there. I probably would've taken a long time to get round to addressing the issue anyway because I would have blamed myself for my situation and in any case seen the world quite blackly. There might have been incidents of sufficiently severe but non-fatal self-harm which would've brought me to the attention of mental health services if I hadn't been as careful and unusual as I in fact have been in how I practiced non-fatal self-harm. Nonetheless, I imagine I would've been in the same pickle, and at that point I would probably have decided I was worthless and that the lack of help from mental health services was nothing other than just desserts. Also, I wouldn't be proactive in chivvying them along. Nobody is likely to jump the queue left to themselves here. On the other hand, they might remove themselves from the queue entirely by doing themselves in (don't - it's a sure way to guarantee things will never get better). Even as it stands, I have moments when I think maybe the TERFs are right and that means it would be rational to kill myself, which is what hope has done to my mind, but don't worry, it's not a realistic prospect. The point is that that is an urge not acted upon but nonetheless felt by someone who isn't even depressed. If it does that to me, what does it do to someone who is genuinely depressed?

If you were of a ruthless enough persuation, you could be forgiven for saying that depressive people are such a drain on resources that they should just be allowed to kill themselves anyway. Then they've removed themselves from the gene pool and society can concentrate on people who are not worthless. That is of course a pretty nasty take on life. Thankfully, it's not coherent. These people have potential and that is lost to society while they are waiting for help from mental health services. Therefore, giving them a little more help in this area would reap dividends aplenty. It's not a case of supporting lame ducks or throwing resources into a hole which can never be filled, although when that happens it's still worthwhile because all people are of infinite value. It's actually an investment in society and the economy. Someone who lacks confidence and experience because of their depression can have their life turned around by shortening waiting lists, and of course similar things apply to physical health needs. I am now convinced that the biggest barrier to my productivity, to look at it in crass, non-compassionate narrow economic terms, has always been gender dysphoria. Take the word "gender" out of that and you multiply that loss to the world by thousands or millions.

Lack of investment in mental health services doesn't just hurt the people who need it directly or even just them and the people close to them. It hurts us all.

After the police broke into Geoffrey Pyke's room after he had killed himself in 1948, they couldn't work out why all the furniture was on the ceiling. If the reason for that was not obvious, it's a telling sign of what's missing from the human race and of lost opportunities for not addressing depression.